About Dystonic Posture

Muscle groups twist or freeze into postures with dystonia, a neurological disorder. The severity of the condition varies from mild to severe. It mostly manifests in the neck, jaw and arms but can also be seen in the legs and toes. In severe cases the person may have a posture that is quite misshapen. Dystonia can affect a single area of the body (called focal dystonia) or one half of the body (hemidystonia), or it can affect many different areas at the same time. Dystonia has many causes and few cures.

Causes of Dystonia

• The causes of dystonia are not clear. There may be some association with the basal ganglia, an area of the brain that controls movement, thus the condition might be characterized as "cross talk" between the nerves. The patient would like to move one set of muscles and another set of muscles is unintentionally affected.

  Cerebral palsy, stroke, tumors and various diseases may manifest as dystonia. Furthermore, many drugs and chemical conditions within the body lead to dystonia.

  There are isolated cases of muscles becoming dystonic due to the long-term adaptive use of some muscles for other functions. There are also cases of dystonia due to difficult births. Some dystonias are limited; for instance, a person may see problems only when he writes, gripping his pen hard. Some dystonia is genetic.

Muscles Wrestling Against Each Other

• One aspect of dystonia is that muscle pairs (adductors/abductors), which usually work in concert by one contracting and the other relaxing, are both contracted, causing an abnormal position. Any corresponding but unaffected muscles may attempt to normalize the posture. This could result in a tonic condition (stiffness), or something that appears like a spasm or shaking. The person may try to counteract the dystonic muscle, because it may be painful, which may lead to changes in position.

Positions of Dystonia

• In the neck the dystonia may be called torticollis and may make the head tilt to one side, twist forward and/or tilt backward. The activated muscles might change, and thus the position might change, or the muscles might change with no visible difference.

  Hands can appear as if they have "writer's cramp," with fingers folded inward in uneven ways and wrists swiveled inward. Elbows may be raised and fingers may be pointed. Arms may turn in at the elbow.

  Facial muscles could pull to one side, something that is more common in older people. The tongue may also be affected and may twist within the mouth, making eating difficult. The jaw may be open or clamped shut.

  In spasmodic dystonia, the vocal cords are affected and the voice may sound strangled.

Relaxing the Dystonic Muscles

• One treatment for severe dystonia is injections of botulism-like substances that basically kill certain nerves, releasing the muscle. In a limited number of cases L-dopa, a neurotransmitter, can offer some relief. In severe cases doctors may resort to surgical denervation to help the patient relax the muscles to achieve a normal posture. In simple cases normal relaxation therapy (massage, heat) may help, or the patient may just adapt to performing the precipitating activity in a different way.

Chances of Getting It

• Dystonia is considered relatively rare, but because there are so many ways to get it and so many precipitating factors, the chance of someone having some type of dystonia in his lifetime is considerable. Staying in good health to avoid a stroke and avoiding psychoactive drugs are two things that lower a person's risk of getting dystonia.